Objective:To evaluate the immunogenicity and immune persistence of human rabies vaccine (Vero cell) in healthy people aged 10-17 years and compare it with a group of adults aged 18-60 years.Methods:This study was conducted between July 2021 and November 2022 with Shangyu district and Shengzhou city of Shaoxing city, Zhejiang Province selected as the research sites. Zagreb regimen (2-1-1 schedule) and Essen regimen (1-1-1-1-1 schedule) were used for rabies vaccine administration. Serum samples were collected at different time points before and after immunization to compare the differences in seropositivity rates and geometric mean concentrations (GMC) between the 10-17 age group and the 18-60 age group.Results:A total of 1 200 healthy participants aged 10-60 were included, with 157 individuals (13.1%) in the 10-17 age group and 1 043 individuals (86.9%) in the 18-60 age group. Both groups displayed a nearly 100% seropositivity rate at 3, 6 and 12 months, and the participants in the same age group had similar antibody levels. The GMC of antibodies gradually increased after vaccination and peaked on 14 d. The 10-17 age group showed higher GMC of antibodies than the 18-60 age group at 14 d after the first dose (Zagreb regimen: 81.85 IU/ml vs 63.15 IU/ml, t=2.411, P=0.018; Essen regimen: 86.61 IU/ml vs 69.24 IU/ml, t=3.906, P<0.001). Similar differences were observed in the GMC of antibodies at 14 d and 3 months after the full vaccination course, but these differences gradually decreased and disappeared at 6 and 12 months after vaccination. Conclusions:Human rabies vaccine (Vero cell) has lasting immune protection in all participants within one year after vaccination, with no significant differences between the two vaccination regimens. Participants aged 10-17 have higher antibody levels compared to adults aged 18-60, but there is no significant difference in immune persistence between the two age groups.

Objective:To evaluate the immunogenicity and immune persistence of human rabies vaccine (Vero cell) in healthy people aged 10-17 years and compare it with a group of adults aged 18-60 years.Methods:This study was conducted between July 2021 and November 2022 with Shangyu district and Shengzhou city of Shaoxing city, Zhejiang Province selected as the research sites. Zagreb regimen (2-1-1 schedule) and Essen regimen (1-1-1-1-1 schedule) were used for rabies vaccine administration. Serum samples were collected at different time points before and after immunization to compare the differences in seropositivity rates and geometric mean concentrations (GMC) between the 10-17 age group and the 18-60 age group.Results:A total of 1 200 healthy participants aged 10-60 were included, with 157 individuals (13.1%) in the 10-17 age group and 1 043 individuals (86.9%) in the 18-60 age group. Both groups displayed a nearly 100% seropositivity rate at 3, 6 and 12 months, and the participants in the same age group had similar antibody levels. The GMC of antibodies gradually increased after vaccination and peaked on 14 d. The 10-17 age group showed higher GMC of antibodies than the 18-60 age group at 14 d after the first dose (Zagreb regimen: 81.85 IU/ml vs 63.15 IU/ml, t=2.411, P=0.018; Essen regimen: 86.61 IU/ml vs 69.24 IU/ml, t=3.906, P<0.001). Similar differences were observed in the GMC of antibodies at 14 d and 3 months after the full vaccination course, but these differences gradually decreased and disappeared at 6 and 12 months after vaccination. Conclusions:Human rabies vaccine (Vero cell) has lasting immune protection in all participants within one year after vaccination, with no significant differences between the two vaccination regimens. Participants aged 10-17 have higher antibody levels compared to adults aged 18-60, but there is no significant difference in immune persistence between the two age groups.

In this study, we explored the neural mechanism underlying impaired stereopsis and possible functional plasticity after strabismus surgery. We enrolled 18 stereo-deficient patients with intermittent exotropia before and after surgery, along with 18 healthy controls. Functional magnetic resonance imaging data were collected when participants viewed three-dimensional stimuli. Compared with controls, preoperative patients showed hypoactivation in higher-level dorsal (visual and parietal) areas and ventral visual areas. Pre- and postoperative activation did not significantly differ in patients overall; patients with improved stereopsis showed stronger postoperative activation than preoperative activation in the right V3A and left intraparietal sulcus. Worse stereopsis and fusional control were correlated with preoperative hypoactivation, suggesting that cortical deficits along the two streams might reflect impaired stereopsis in intermittent exotropia. The correlation between improved stereopsis and activation in the right V3A after surgery indicates that functional plasticity may underlie the improvement of stereopsis. Thus, additional postoperative strategies are needed to promote functional plasticity and enhance the recovery of stereopsis.
Humans ; Exotropia/surgery* ; Depth Perception/physiology* ; Strabismus/surgery* ; Oculomotor Muscles/surgery*

Objective:To observe and analyze the effect of double and single bridge exercise on the electromyographic activities of related core muscle groups in stroke patients, and to explore its rules and characteristics.Methods:A prospective cohort study was conducted on 40 stroke patients hospitalized in the Department of rehabilitation medicine, Hefei second people's Hospital, Anhui Province from March 2020 to May 2021.The surface electromyography (sEMG) instrument was used to collect the surface electromyographic signals of erector spinalis, rectus abdominis, gluteus maximus and biceps femoris during double and single bridge exercise, and the root mean square (RMS) and integrated electromyography (iEMG) of the time domain indexes were analyzed. The measurement data conforming to normal distribution was expressed in xˉ± s.The non normal distribution data was expressed in M (Q1, Q3). Wilcoxon rank sum test was used to compare the difference between the two groups. Results:There was significant difference between RMS (30.0 (21.3, 45.5) μV vs. 24.0 (14.0, 35.8) μV) and IEMG (15.5. (10.0, 23.0) μV?s vs. 9.0 (5.0, 13.0) μV?s s) values of gluteus maximus on the healthy side and the affected side during double bridge exercise ( Z values were 2.07, 4.19; P values were 0.039, <0.001, respectively). There was significant difference in RMS (31.0 (15.3, 70.0) μV ratio of the healthy and affected biceps femoris 17.0 (11.0, 28.8) μV) and IEMG (14.5 (8.0, 26.5) μV?s vs. 7.0 (5.0, 10.8) μV?s) values of biceps femoris on the healthy side during double bridge exercise ( Z values were 3.44, 3.64; P values were 0.001 and <0.001, respectively ). There was significant difference between RMS(38.5(32.3, 46.0) μV vs. 35.0(22.3, 43.0) μV) and IEMG (16.5(12.0, 22.8) μV?s vs. 12.0(7.0, 21.0) μV?s) values of the gluteus maximus on the healthy side during single bridge exercise ( Z values were 2.24, 2.45; P values were 0.025, 0.014, respectively). There was significant difference between RMS (38.0 (15.3, 70.0) μV vs. 19.0 (12.0, 35.5) μV) and IEMG (16.0 (10.0, 27.0) μV?s vs. 6.5 (5.0, 12.5) μV?s s) values of biceps femoris on the healthy side during single bridge exercise ( Z values were 2.98,4.34; P values were 0.003 and <0.001, respectively). There was significant difference between RMS (24.0 (14.0, 35.8) μV vs. 35.0 (22.3, 43.0) μV) and IEMG (9.0 (5.0, 13.0) μV?s vs. 12.0 (7.0, 21.0) μV?s) values of double and single gluteus maximus on the affected side ( Z values were 2.24, 1.99; P values were 0.025,0.047, respectively). Conclusion:Double bridge and single bridge exercise could improve the related core muscle groups of stroke patients with hemiplegia, and single bridge was better than double bridge for the activation of gluteus maximus

Under the combination of postgraduate education and standardized medical residents training, via exploring current situation, we put forward the limitations of routine rotation training, disconnection of theory and practice, inefficient of scientific ability. We arouse a new model by improving teaching model, enriching teaching content, optimizing teaching method, making better arrangement of rotations and cultivating scientific ability to provide references for enhancing the ability of clinical thinking, practice, scientific research and communication.

Objective:To compare the protective effects of cerebral blood flow during simulated push pull maneuver (PPM) between lower body negative pressure (LBNP) strategy and thigh cuff (TC) strategy.Methods:It was a repeated cross-over design study. Fifteen healthy young male subjects were recruited. All subjects underwent the control bout (simulated PPM without any intervention), PPM with LBNP bout, and PPM with TC bout. Such position changes as "upright to head down tilt to upright" were performed by tilting table to simulate PPM. The control bout underwent normal PPM. LBNP of -40 mmHg (1 mmHg=0.133 kP) was applied prior to and during -G z stress and released at the subsequent transition to +G z stress in LBNP bout. TC of +200 mmHg was applied at bilateral upper thighs prior to and during simulated PPM. Beat-to-beat cerebral and systemic hemodynamics of the subjects were continuously recorded. Results:During the rapid -G z to +G z transition, the mean cerebral blood flow velocity (CBFVm) was decreased by 0.7-17.3 cm/s [ΔCBFVm=(-7.5±4.5) cm/s], and the mean arterial pressure at the level of middle cerebral artery(MAP MCA) was decreased by 42-76 mmHg [ΔMAP MCA=(-61.0±10.0) mmHg] in control bout. However, the change of CBFVm was -2.4-10.2 cm/s in LBNP bout, whose average value was increased (3.3±4.1) cm/s rather than decreased. The drop of MAP MCA was 23-50 mmHg [ΔMAP MCA=(-41.0±11.0) mmHg], which was significantly reduced than that in control bout ( P<0.05). The change of CBFVm in TC bout was -7.9-1.4 cm/s [ΔCBFVm=(-3.0±4.2) cm/s], and the decrease of ΔMAP MCA was 37-59 mmHg [ΔMAP MCA=(-47.0±13.0) mmHg], both of which were significantly smaller than that in control bout ( P<0.05). There was significant difference in ΔCBFVm between LBNP and TC bouts ( P<0.05), while no significant difference was found in ΔMAP MCA. Conclusions:Both the LBNP and TC strategies can protect the cerebral blood flow during simulated PPM. LBNP strategy showed better improvement of CBFVm than TC. Both strategies demonstrated protective effect by increasing diastolic cerebral blood flow.

Objective:To compare the protective effects of cerebral blood flow during simulated push pull maneuver (PPM) between lower body negative pressure (LBNP) strategy and thigh cuff (TC) strategy.Methods:It was a repeated cross-over design study. Fifteen healthy young male subjects were recruited. All subjects underwent the control bout (simulated PPM without any intervention), PPM with LBNP bout, and PPM with TC bout. Such position changes as "upright to head down tilt to upright" were performed by tilting table to simulate PPM. The control bout underwent normal PPM. LBNP of -40 mmHg (1 mmHg=0.133 kP) was applied prior to and during -G z stress and released at the subsequent transition to +G z stress in LBNP bout. TC of +200 mmHg was applied at bilateral upper thighs prior to and during simulated PPM. Beat-to-beat cerebral and systemic hemodynamics of the subjects were continuously recorded. Results:During the rapid -G z to +G z transition, the mean cerebral blood flow velocity (CBFVm) was decreased by 0.7-17.3 cm/s [ΔCBFVm=(-7.5±4.5) cm/s], and the mean arterial pressure at the level of middle cerebral artery(MAP MCA) was decreased by 42-76 mmHg [ΔMAP MCA=(-61.0±10.0) mmHg] in control bout. However, the change of CBFVm was -2.4-10.2 cm/s in LBNP bout, whose average value was increased (3.3±4.1) cm/s rather than decreased. The drop of MAP MCA was 23-50 mmHg [ΔMAP MCA=(-41.0±11.0) mmHg], which was significantly reduced than that in control bout ( P<0.05). The change of CBFVm in TC bout was -7.9-1.4 cm/s [ΔCBFVm=(-3.0±4.2) cm/s], and the decrease of ΔMAP MCA was 37-59 mmHg [ΔMAP MCA=(-47.0±13.0) mmHg], both of which were significantly smaller than that in control bout ( P<0.05). There was significant difference in ΔCBFVm between LBNP and TC bouts ( P<0.05), while no significant difference was found in ΔMAP MCA. Conclusions:Both the LBNP and TC strategies can protect the cerebral blood flow during simulated PPM. LBNP strategy showed better improvement of CBFVm than TC. Both strategies demonstrated protective effect by increasing diastolic cerebral blood flow.

ObjectiveTo investigate the safety and clinical effect of pancreaticoduodenectomy with total mesopancreas excision (TMpE) versus traditional pancreaticoduodenectomy (PD) in the treatment of pancreatic head carcinoma and periampullary cancer. MethodsPubMed, Web of Science, Cochrane Library, CBM, CNKI, Wanfang Data, and VIP were searched for the Chinese and English articles on the clinical effect of TMpE and PD in the treatment of pancreatic head carcinoma and periampullary cancer published from January 2007 to February 2020. Quality assessment was performed for the articles included, and Revman 5.3 software was used to perform the Meta-analysis. ResultsFive retrospective cohort studies were included after screening, with a total of 358 patients, among whom 188 underwent TMpE and 170 underwent PD. The results of the meta-analysis showed that compared with the PD group, the TMpE group had a significant increase in the incidence rate of pancreatic fistula (odds ratio ［OR］=1.69, 95% confidence interval ［CI］: 1.03-2.78, P=0.04), while there was no significant difference in the incidence rate of postoperative complications between the two groups (OR=1.51, 95% CI: 0.76-2.98, P=0.24). In addition, TMpE improved R0 resection rate (OR=2.89, 95% CI: 1.30-6.43, P=0.009), number of dissected lymph nodes (mean difference ［MD］=5.14, 95% CI: 4.16-6.13, P＜0.001), and 1-year survival rate after surgery (OR=260, 95% CI: 1.45-4.69, P=0.001), without increasing the time of operation (MD=7.74, 95% CI: -42.84 to 58.33, P=076), intraoperative blood loss (MD = -45.89, 95% CI: -198.19 to 106.41, P=0.55), and the length of postoperative hospital stay (MD=-4.62, 95% CI: -16.60 to 7.36, P=0.45). ConclusionTMpE is safe and feasible in the treatment of pancreatic head carcinoma and periampullary cancer and has the advantages of high R0 resection rate and 1-year survival rate after surgery, and therefore, it may become a preferred treatment method for pancreatic head carcinoma and periampullary cancer.

The mammalian central nervous system (CNS) is considered an immune privileged system as it is separated from the periphery by the blood brain barrier (BBB). Yet, immune functions have been postulated to heavily influence the functional state of the CNS, especially after injury or during neurodegeneration. There is controversy regarding whether adaptive immune responses are beneficial or detrimental to CNS injury repair. In this study, we utilized immunocompromised SCID mice and subjected them to spinal cord injury (SCI). We analyzed motor function, electrophysiology, histochemistry, and performed unbiased RNA-sequencing. SCID mice displayed improved CNS functional recovery compared to WT mice after SCI. Weighted gene-coexpression network analysis (WGCNA) of spinal cord transcriptomes revealed that SCID mice had reduced expression of immune function-related genes and heightened expression of neural transmission-related genes after SCI, which was confirmed by immunohistochemical analysis and was consistent with better functional recovery. Transcriptomic analyses also indicated heightened expression of neurotransmission-related genes before injury in SCID mice, suggesting that a steady state of immune-deficiency potentially led to CNS hyper-connectivity. Consequently, SCID mice without injury demonstrated worse performance in Morris water maze test. Taken together, not only reduced inflammation after injury but also dampened steady-state immune function without injury heightened the neurotransmission program, resulting in better or worse behavioral outcomes respectively. This study revealed the intricate relationship between immune and nervous systems, raising the possibility for therapeutic manipulation of neural function via immune modulation.

Objective To investigate the effect and related mechanism of microRNA (miR)-494 on the hepatic ischemia-reperfusion injury (HIRI). Methods Twenty-four male SD rats were randomly divided into four groups (n=6 in each group). In the sham operation group, abdominal surgery without hepatic ischemia-reperfusion was performed. In the HIRI group, partial liver ischemia was performed for 60 min, followed by 6 h perfusion. In the HIRI+agomir-miR-494 group, intraperitoneal injection of agomir-miR-494 (20 μL) was daily given within preoperative 7 d. In HIRI+agomir-NC group, an equivalent quantity of agomir-NC was daily injected intraperitoneally within preoperative 7 d. The expression level of miR-494 messenger RNA(mRNA) in the liver tissues in each group was detected by reverse transcription polymerase chain reaction (RT-PCR). The expression levels of liver injury and oxidative stress related indexes were measured by relevant kits. The histopathological changes of the liver in each group were observed. The quantity of apoptotic cells and cytoplasmic histone-related DNA fragments in the liver tissues of rats was detected by relevant kits. The expression levels of the proteins related to the phosphatidylinositol-3-kinase(PI3K)/protein kinase(AKT) signaling pathway were measured by Western blot. Results The expression level of miR-494 mRNA in the rat liver tissues in the HIRI+agomir-miR-494 group was significantly higher than that in the HIRI+agomir-NC group (P < 0.01). The levels of the serum liver injury and oxidative stress related indexes in the HIRI+agomir-miR-494 group were significantly lower than those in the HIRI+agomir-NC group (all P < 0.01). Compared with those in the HIRI+agomir-NC group, the quantity of cellular necrosis was significantly reduced, the cell integrity was considerably increased and the quantity of TUNELpositive cells was evidently decreased in the HIRI+agomir-miR-494 group (all P < 0.05). The expression levels of poly ADP-ribose polymerase(PARP), cysteinyl aspartate specific proteinase-3(Caspase-3) and Bax in the HIRI+agomirmiR-494 group were significantly lower than those in the HIRI+agomir-NC group (all P < 0.05). The quantity of DNA fragments in the HIRI+agomir-miR-494 group was significantly less than that in the HIRI+agomir-NC group (P < 0.01). The expression levels of p-AKT, p-mammalian target of rapamycin(mTOR) and p-p70S6K in the HIRI+agomir-miR-494 group were significantly higher than those in the HIRI+agomir-NC group (all P < 0.05). Conclusions miR-494 can alleviate the severity of HIRI in rats by activating the PI3K/AKT signaling pathway.